The Battle Over Hydrocodone: Revisited

This blog, first and foremost, is intended to be informative and educational. My goal has always been to cast about with opinions and the allow others to offer feedback, guidance, and perspective.

Such has been the case since I advocated for moving hydrocodone-containing medications from schedule III to schedule II. On Monday, I wrote about the controversy regarding a provision drafted by Sen. Joe Manchin (D - WV) that would provide for such a reclassification.

In response to that post, I heard from several pharmacists that disagreed with my position.

First, it was pointed out that hydrocodone-acetaminophen is an acute medication and changing it to a schedule II drug may inhibit access to patients that need it quickly. I pointed out that data suggests the drug is often used for chronic pain management, too. That brought this response from a pharmacist: "Hydrocodone is often used chronically, although it is often for breakthrough pain and often with a long acting opioid. Hydrocodone/APAP would not be the sole pain medication. Data from a large carrier in Q4 2011 shows 14% of mature patients using hydrocodone (3 years or older) are using it with a long acting opioid."

Another issue, perhaps more relevant to the battle over abuse and addiction of prescription drugs: "Reclassifying hydrocodone/apap products as a CII does not address the inappropriate and over prescribing of this medication and opioids in general. All it will do is create undue burden on pharmacists and patients without addressing the real problem. Physicians generally do not care how much work or regulatory hoops pharmacists have to jump through to fill a prescription." Good point.

What we all decided to agree upon, though, is the fact that Zohydro (a single ingredient hydrocodone drug as a controlled release long acting opioid - currently pending FDA approval) should be a schedule II drug.

Thanks to all for the input.
Michael
On Twitter @PRIUM1